The proposed research will develop a wearable awareness enhancement and monitoring device (AEMD) which will assist the treatment of trichotillomania, a repetitive hair pulling disorder that leads to noticeable hair loss. The device will monitor relative body position between the hand and the effected hair, creating awareness by signaling the user, using vibration and/or sound, prior to pulling. The device will have monitoring capabilities which will allow for users to classify the nature of each hand to body touching incident as a hair pull, a near pull, or as an incidental touch. These incidents and their classification will be logged with a time and date stamp and downloaded to a personal computer for analysis and graphic presentation. The device can function with both the alert and monitoring features activated or it can simply monitor behaviors without the alarm feature. The proposed Phase I device is a small signaling mechanism which will have triggering elements worn near the head, elements containing a sensor and Bluetoothtm RF communication worn on or near the hands, and an alarm, Bluetoothtm RF communication and data logging element (a Bluetoothtm enabled commercially available personal data assistant - PDA) worn at the waist or in a pocket. During Phase I, prototypes will be developed and tested for size, weight and battery life, the ability to signal at programmed distances/durations between the hand and head, and for other functions. It will be non-responsive to incidental RF interference, signaling only when the trigger enters the alarm zone. The device has a user-adjustable time delay feature. Users who wish earliest possible habit interruption can select a no delay option whereas those who are sensitive to "false alarms" can set a customized time delay before the device triggers an alert. The device will allow the user to activate a temporary time-off feature allowing for non-destructive hand to head functions (e.g. tooth brushing). Prototypes will be tested on nine human subjects in Phase I. In Phase II, the technology will continue to be developed for miniaturization and manufacturability and we will extend this body of research with human studies conducted on individuals with trichotillomania to determine the efficacy of the device. Research to date suggests that medications and behavior therapy, while helpful, leave many individuals with clinically significant hair pulling and in need of further help. The initial commercial application of the device will be aimed at the 1.8 million plus individuals with trichotillomania in the United States, and it is expected be used in conjunction with existing behavioral therapies. In addition to offering a new treatment for trichotillomania, the proposed device, or modified versions, could be used to help treat other body-focused repetitive behavior problems such as skin picking, finger and nail biting. The goal of the proposed research is to develop a device to assist persons with trichotillomania, a very impairing, commonly undiagnosed and untreated problem involving compulsive hair pulling. This device will help sufferers gain awareness of their hair pulling and will also monitor the frequency and duration of this destructive habit. Available psychological treatments are only partially helpful and this device when integrated with current treatments could substantially improve the lives of sufferers and their families. [unreadable] [unreadable] [unreadable]